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Tuesday, December 15, 2009

Lunch privileges

When I was an intern in the medical ICU, I didn't get along very well with my senior resident. There was a name I used to call her and... well, I'm too polite to say it on this blog, but it started with the letter B and rhymed with "switch."

On my first call in the ICU, my senior resident who I will call Cruella (yes, I've been watching too many Disney movies) sent me to see a patient in the ER. I saw the patient, she came down to see the patient with me, and eventually he was stabilized. It was after 1PM and at that point, Cruella said to me, "Why don't you go get lunch?"

I was quite relieved because the cafeteria was closing soon and I needed to get some food for dinner too, considering I was likely not going to have time to make another trip down there. I got a sandwich (and one for dinner), ate it in maybe five minutes (chewing a total of six times), then went back to the ICU where Cruella promptly paged me.

"Where were you?" she demanded to know.

"I was eating lunch," I stammered.

"I told you to get lunch!" Cruella said angrily. "I didn't say you should eat it!"

I swear to god, she said that.

Cruella's switchiness aside, I feel like lunch is something I've had to fight for ever since starting my clinical years and it's gotten less and less acceptable to me. On my first day of residency, I nearly fainted because I skipped lunch. I attracted quite a crowd and I ended up having to confess to my attending that I was two months pregnant because otherwise she'd think I was a wuss who fainted from removing a G-tube. I also remember there was one day when I was six months pregnant and rounds were lasting forever, well past lunch time... I told my attending I needed to eat because I was feeling faint. She said, "You really think you're going to faint? Okay, let's just round on one more floor of patients, then you can eat." I swear to god, she said that. (And she was actually pretty nice otherwise.)

Moreover, I've noticed it seems commonplace for clinics to be scheduled to go straight through lunch. When I did clinics with surgeons especially, there was never ever a lunch break planned into the day. Surgeons eat maybe one meal every two days, which they eat standing up. I've theorized they must have some sort of bear-like fat storage system to allow them to go for long periods without eating.

Recently, my morning clinics have been running past 1:30 and I feel too embarrassed to complain. I honestly feel like there must be something wrong with me because by 1PM, I am actually really hungry. In fact, I'd rather eat at noon. Am I really the only one? Am I weak for needing to eat lunch? Should people who need to eat lunch avoid medicine entirely?

I don't want to have a gigantic lunch followed by a siesta. All I want is like ten minutes built into the middle of my day when I can sit down and eat some food, preferably with a drink, and not have to apologize for it.

I hear you !! I've taken to taking muesli bars in my pockets- I'm sure my clinic patients aren't getting the best of me when all I'm thinking of is lunch!! And what is it with operating all day without food! How can they do that??

I totally feel you on this lunch thing. I NEVER get away to eat while at work. I eat while catching up on charting etc. My husband complains of the same thing, never having an opportunity to have 10 minutes to eat during the day. You know I just talked with my 8 year old about this tonight at dinner, because he complained they only have 15 minutes to eat lunch at school and he never gets to finish it. I guess we are training the kids early that lunch is to be done without?

Not unreasonable at all. Although I have the surgeon "bear-like fat storage system" you refer to, according to my husband, because I CAN and often do function pretty well all day without a meal, I don't think it's a good idea for anyone. What message does it send our patients when we don't eat properly? Or at all? Don't exercise? It's really not asking too much for a sacred time to be built into midday for a meal. I actually like it when I call referring physician offices at 12:30pm and get the automated msg that the office is closed for lunch between 12 and 1. So civilized. Although, come to think of it, they do always have a little disclaimer that if you are a physician trying to reach a physician to press zero or something to be connected. Oh well. Sigh...

Special K protein bars have been my life-saver; they're individually wrapped and I can put one into a pocket or bag to carry with me. I learned the hard way that I need to eat regularly, after fainting during a c-section as a med student. My husband is one of those who can eat once every two or three days, but my kids and I turn into Pure Evil when our blood sugar dips too low...don't feel bad about the need to eat!A

Huge fan of lunch, which I could never eat if I didn't bring it from home or nuke some Lean Cuisine. Luckily my lunch gets made at lunch and put in my car in the morning (best husband EVER!!) so that I can inhale it while reading the tabloids/MSN. Besides, not eating makes me cranky...

In med school I usually devoted an entire pocket in ny white coat to food: granola bars, fruit rollups, cheese and abottle of water. Sometimes I'd make an egg and cheese sandwich and put that in my pocket and eat it between patients on morning rounds. One of my fellow students asked me how I ate constantly and didn't get fat! I just can't go more than 3 hours without eating! Def not the bear fat type...

One of the (many) reasons I went into pathology is so I would never have to go all day without eating. Currently drinking tea next to my personal food drawer, refridgerator, and microwave :)

Me too (Artemis), I love those protein bars!! On full clinical days, the only time I recall definitely have "time" to eat lunch was a few years back when I pumped! I just had to have/take/create time to pump, and so, alas, I ate during that precious 20-30 minutes of pumping. Now it's "better" as I eat while working on the electronic medical record from morning patients.

I still remember getting paged away from the lunch line in the cafeteria during my cytology fellowship, again and again. I would look down mournfully at my chosen food and apologetically abandon it. Now I have a giant food drawer in my office - combating the PTSD from those experiences. When it starts getting slightly low, I develop uncontrollable anxiety. Everyone in the lab jokes that if there was a natural disaster, they could live for months off of the food in my office.

gosh, i have such different feelings reading this post... we (residents) don't get lunch. but we don't get more than 3 weeks vacation, or less thank 80 hour work weeks, or 8 hours of sleep at one time, or time to exercise/go to the grocery store/wrap presents or anything. lunch is the only thing i can work around fairly easily. from 3rd year in med school on i learned to carry a granola bar in one coat pocket and a shorty water bottle in another (actually it's a sigg flask, really really great). so much about what we do sucks beyond sucking and no one tells you the sacrifices until it's too late to back out. but it's what we do and until our culture changes, we're stuck thinking of ourselves (or being perceived as) the weak ones because we have to eat.

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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